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Immunotherapy toxicities

Immunotherapy toxicities Dr Fiona Taylor Outline Understand toxicities Key steps to safely using and Anticipate toxicities achieving the most benefits from immunotherapies for patients Manage toxicities Immunotherapies are novel agents Increasing use NICE/CDF approved Clinical Trials Therefore more likely to encounter patients with Immunotherapy toxicities On the wards, in clinics, calling the hotline . toxicities may become more complicated Combination with chemotherapy, radiotherapy and other immunotherapies Patient assessment How are you going to assess a patient commencing Immunotherapy ? Baseline assessment Clinical PS 0 or 1 or 2. Co-morbidities Autoimmune diseases Medications prednisolone, potential drug interactions Bloods FBC U+E LFTs Blood borne viruses HIV, Hep B and C. Quantiferon test active or latent TB. Baseline hormone/endocrine profile FSH, LH, oestradiol/testosterone prolactin 9am cortisol, ACTH.

Osteoporosis •Check Vitamin D and calcium consider bisphosphonate if on steroids for >3months . How are you going to assess a patient for immunotherapy toxicities? Immunotherapy toxicity assessment Clinical history +/- examination Skin Rash, itch, examine GI Diarrhoea, abdominal pain, nausea, vomiting ...

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